Effect of late-onset on multiple sclerosis phenotype and outcome: evidence from a multi-national registry.
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Souissi Amira, Patti Francesco, Spelman Tim, Chisari Clara, Gargouri Amina, John Nevin, Kermode Allan G, Kalincik Tomas, Butzkueven Helmut, Sajedi Seyed Aidin, Lechner-Scott Jeannette, Roos Izanne, Laureys Guy, Taylor Bruce, Alroughani Raed, Khoury Samia J, Macdonell Richard, Weinstock-Guttman Bianca, Havrdova Eva Kubala, Maimone Davide, Reddel Stephen, Fabis-Pedrini Marzena, Willekens Barbara, Moghadasi Abdorreza Naser, Lalive Patrice, Lugaresi Alessandra, Ozakbas Serkan, Solaro Claudio, Cárdenas-Robledo Simón, Shaygannejad Vahid, Etemadifar Masoud, Boz Cavit, Eichau Sara, Tomassini Valentina, Terzi Murat, Prat Alexandre, Habek Mario, Blanco Yolanda, Altintas Ayse, Gerlach Oliver, Turkoglu Recai, Buzzard Katherine, Skibina Olga, Soysal Aysun, van der Walt Anneke, Hughes Stella, van Pesch Vincent, Foschi Matteo, Surcinelli Andrea, Prevost Julie, Ramo-Tello Cristina, McGuigan Chris, Sa Maria Jose, Kuhle Jens, Spitaleri Daniele, Singhal Bhim, Ampapa Radek, de Gans Koen, Petersen Thor, Simu Mihaela, Lapointe Emmanuelle, Sanchez-Menoyo Jose Luis, Gray Orla, Garber Justin, Aguera-Morales Eduardo, Gross-Paju Katrin, Castillo-Triviño Tamara, Al-Asmi Abdullah, Grigoriadis Nikolaos, Inshasi Jihad, Al-Harbi Talal, Hardy Todd A, Ramanathan Sudarshini, Cambron Melissa, Shuey Neil, Sempere Angel Perez, Csepany Tunde, Treviño-Frenk Irene, Rozsa Csilla, Cauchi Marija, Karabudak Rana, Mrabet Saloua, Gouider Riadh
Аннотация
METHODS: We conducted an observational study using data from the MSBase registry and categorized patients based on age at MS onset: AOMS (18-39 years), transition onset (40-49 years), LOMS (50-59 years), and vLOMS (≥ 60 years). Disease progression was assessed using the 24 week confirmed disability progression, EDSS4 and 6 milestones, conversion to secondary progressive MS(SPMS), and the first progression independent of relapse activity (PIRA) event. Cox proportional hazard regression models were used to determine unadjusted hazard ratios(HR), and propensity score inverse probability of treatment weighting(PS-IPTW) balanced covariate distributions.
RESULTS: Among 81,236 patients, 5.2% had LOMS and 1% had vLOMS. Primary progressive MS was more frequent in LOMS and vLOMS (21.7 and 24%, respectively). Patients with LOMS and vLOMS had a significantly increased risk of 24 week confirmed disability progression (HR:LOMS = 1.39, vLOMS = 1.80), EDSS 4 (HR:LOMS = 2.14, vLOMS = 2.95), EDSS 6 (HR:LOMS = 2.33, vLOMS = 6.33), SPMS (HR:LOMS = 1.62, vLOMS = 2.38), and first PIRA event (HR:LOMS = 2.12, vLOMS = 2.93).
CONCLUSION: LOMS and vLOMS exhibited a more progressive disease onset and higher disability milestones compared with AOMS.